Atrial Septal Defect with Rheumatic Mitral Regurgitation: A Rare Association in a Nigerian Child

Olugbenga Olalekan Ojo; Uvie Ufuoma Onakpoya; John Akintunde Okeniyi; Anthony Taiwo Adenekan; Muyiwa Afolabi Owojuyigbe; Oluwakemi Tolu Adegoke

doi:doi:10.11648/j.ijcts.20190503.12

Atrial Septal Defect with Rheumatic Mitral Regurgitation: A Rare Association in a Nigerian Child

Olugbenga Olalekan Ojo, Uvie Ufuoma Onakpoya, John Akintunde Okeniyi, Anthony Taiwo Adenekan, Muyiwa Afolabi Owojuyigbe, Oluwakemi Tolu Adegoke

Published in International Journal of Cardiovascular and Thoracic Surgery (Volume 5, Issue 3)

Received: 12 August 2019 Accepted: 3 September 2019 Published: 18 September 2019

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Abstract

Atrial septal defect (ASD) coexisting with mitral valve regurgitation has been described in literature with various aetiologies and pathophysiologic mechanisms. Mitral valve lesions coexisting with an ASD could either be congenital or acquired. The most prominent congenital mitral valve pathology is a cleft in the anterior leaflet of the mitral valve, as seen in patients with partial atrio-ventricular septal defects. Acquired mitral valve lesions include, hemodynamic induced annular dilatation resulting in significant mitral regurgitation, iatrogenic leaflet perforation and coexisting diseases such as infective endocarditis or rheumatic valve disease. However, the aetiology of the mitral valve regurgitation being due to rheumatic heart disease is uncommon. We report the case of a 12-year-old female who presented with easy fatigability, palpitation and a precordial bulge dating about 2 years. Examination revealed cardiac murmurs in the apex and pulmonary areas and transthoracic echocardiography confirmed the presence of an Ostium Secundum ASD and features of severe rheumatic mitral valve regurgitation. Child was initially placed on medications which included diuretics and an Angiotensin converting enzyme inhibitor ACEi, before she eventually had surgical closure of ASD and mitral valve replacement. The purpose of this case report is to highlight the symptomatology, diagnosis and treatment of this rare association, particularly in our environment.

Published in	International Journal of Cardiovascular and Thoracic Surgery (Volume 5, Issue 3)
DOI	10.11648/j.ijcts.20190503.12
Page(s)	60-63
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Atrial Septal Defect, Ostium Secundum (OS), Rheumatic, Mitral Valve Regurgitation, Transthoracic Echocardiography

References

[1]	Nasreen A, Sunil KA. Congenital heart disease (Atrial septal defect) with Rheumatic heart disease (Mitral Regurgitation) - A rare association. JMSCR 2017; 5 (7): 25003 - 5.
[2]	Waikittipong S. Mitral regurgitation associated with Secundum Atrial Septal Defect. Thai J Surgery 2010 Oct. 1; 31 (4); 120-4.
[3]	Mavroudis C, Backer CL. Pediatric cardiac surgery. 4th ed. Wiley-Blackwell, 2013: pg. 297.
[4]	Ballester M, Presbitero P, Foale R. Prolapse of the mitral valve in secundum atrial septal defect: A functional mechanism. Eur Heart J 1983; 7: 472-7.
[5]	Davies MJ. Mitral valve in Secundum atrial septal defects. Br Heart J 1981; 46: 126-8.
[6]	Furuta S, Wanibuchi Y, Ino T, Aoki K. Aetiology of mitral regurgitation in secundum atrial septal defect. Jap Circulation J 1982; 46: 346-51.
[7]	Lutembacher R. De la stenose mitrale avec communication interauriculaire. Arch Mal Coeur 1916; 9: 237-60.
[8]	Jain VV, Gupta OP, Jain J. A rare case of situs inversus with dextrocardia, Lutembacher syndrome and pericardial effusion. Heart Views 2011; 12: 107-11.
[9]	Barman B, Kapoor M, Lynrah KG, Issar NK, Nath D. Lutembacher's syndrome: A rare cause of right heart failure. J Cardiovasc Dis Res 2016; 7: 52-5.
[10]	Perloff JK, Marelli AJ. eds. The Clinical recognition of Congenital Heart Disease. 4th ed. Philadelphia: WB Saunders, 1994: 323-8.

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APA Style

Olugbenga Olalekan Ojo, Uvie Ufuoma Onakpoya, John Akintunde Okeniyi, Anthony Taiwo Adenekan, Muyiwa Afolabi Owojuyigbe, et al. (2019). Atrial Septal Defect with Rheumatic Mitral Regurgitation: A Rare Association in a Nigerian Child. International Journal of Cardiovascular and Thoracic Surgery, 5(3), 60-63. https://doi.org/10.11648/j.ijcts.20190503.12

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ACS Style

Olugbenga Olalekan Ojo; Uvie Ufuoma Onakpoya; John Akintunde Okeniyi; Anthony Taiwo Adenekan; Muyiwa Afolabi Owojuyigbe, et al. Atrial Septal Defect with Rheumatic Mitral Regurgitation: A Rare Association in a Nigerian Child. Int. J. Cardiovasc. Thorac. Surg. 2019, 5(3), 60-63. doi: 10.11648/j.ijcts.20190503.12

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AMA Style

Olugbenga Olalekan Ojo, Uvie Ufuoma Onakpoya, John Akintunde Okeniyi, Anthony Taiwo Adenekan, Muyiwa Afolabi Owojuyigbe, et al. Atrial Septal Defect with Rheumatic Mitral Regurgitation: A Rare Association in a Nigerian Child. Int J Cardiovasc Thorac Surg. 2019;5(3):60-63. doi: 10.11648/j.ijcts.20190503.12

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@article{10.11648/j.ijcts.20190503.12,
  author = {Olugbenga Olalekan Ojo and Uvie Ufuoma Onakpoya and John Akintunde Okeniyi and Anthony Taiwo Adenekan and Muyiwa Afolabi Owojuyigbe and Oluwakemi Tolu Adegoke},
  title = {Atrial Septal Defect with Rheumatic Mitral Regurgitation: A Rare Association in a Nigerian Child},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {5},
  number = {3},
  pages = {60-63},
  doi = {10.11648/j.ijcts.20190503.12},
  url = {https://doi.org/10.11648/j.ijcts.20190503.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20190503.12},
  abstract = {Atrial septal defect (ASD) coexisting with mitral valve regurgitation has been described in literature with various aetiologies and pathophysiologic mechanisms. Mitral valve lesions coexisting with an ASD could either be congenital or acquired. The most prominent congenital mitral valve pathology is a cleft in the anterior leaflet of the mitral valve, as seen in patients with partial atrio-ventricular septal defects. Acquired mitral valve lesions include, hemodynamic induced annular dilatation resulting in significant mitral regurgitation, iatrogenic leaflet perforation and coexisting diseases such as infective endocarditis or rheumatic valve disease. However, the aetiology of the mitral valve regurgitation being due to rheumatic heart disease is uncommon. We report the case of a 12-year-old female who presented with easy fatigability, palpitation and a precordial bulge dating about 2 years. Examination revealed cardiac murmurs in the apex and pulmonary areas and transthoracic echocardiography confirmed the presence of an Ostium Secundum ASD and features of severe rheumatic mitral valve regurgitation. Child was initially placed on medications which included diuretics and an Angiotensin converting enzyme inhibitor ACEi, before she eventually had surgical closure of ASD and mitral valve replacement. The purpose of this case report is to highlight the symptomatology, diagnosis and treatment of this rare association, particularly in our environment.},
 year = {2019}
}

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TY  - JOUR
T1  - Atrial Septal Defect with Rheumatic Mitral Regurgitation: A Rare Association in a Nigerian Child
AU  - Olugbenga Olalekan Ojo
AU  - Uvie Ufuoma Onakpoya
AU  - John Akintunde Okeniyi
AU  - Anthony Taiwo Adenekan
AU  - Muyiwa Afolabi Owojuyigbe
AU  - Oluwakemi Tolu Adegoke
Y1  - 2019/09/18
PY  - 2019
N1  - https://doi.org/10.11648/j.ijcts.20190503.12
DO  - 10.11648/j.ijcts.20190503.12
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 60
EP  - 63
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20190503.12
AB  - Atrial septal defect (ASD) coexisting with mitral valve regurgitation has been described in literature with various aetiologies and pathophysiologic mechanisms. Mitral valve lesions coexisting with an ASD could either be congenital or acquired. The most prominent congenital mitral valve pathology is a cleft in the anterior leaflet of the mitral valve, as seen in patients with partial atrio-ventricular septal defects. Acquired mitral valve lesions include, hemodynamic induced annular dilatation resulting in significant mitral regurgitation, iatrogenic leaflet perforation and coexisting diseases such as infective endocarditis or rheumatic valve disease. However, the aetiology of the mitral valve regurgitation being due to rheumatic heart disease is uncommon. We report the case of a 12-year-old female who presented with easy fatigability, palpitation and a precordial bulge dating about 2 years. Examination revealed cardiac murmurs in the apex and pulmonary areas and transthoracic echocardiography confirmed the presence of an Ostium Secundum ASD and features of severe rheumatic mitral valve regurgitation. Child was initially placed on medications which included diuretics and an Angiotensin converting enzyme inhibitor ACEi, before she eventually had surgical closure of ASD and mitral valve replacement. The purpose of this case report is to highlight the symptomatology, diagnosis and treatment of this rare association, particularly in our environment.
VL  - 5
IS  - 3
ER  -

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Author Information

Olugbenga Olalekan Ojo

Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Obafemi Awolowo University Teaching Hospital, Ile-ife, Nigeria
Uvie Ufuoma Onakpoya

Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Obafemi Awolowo University Teaching Hospital, Ile-ife, Nigeria
John Akintunde Okeniyi

Department of Paediatrics and Child Health, Obafemi Awolowo University, Obafemi Awolowo University Teaching Hospital, Ile-ife, Nigeria
Anthony Taiwo Adenekan

Department of Paediatrics and Child Health, Obafemi Awolowo University, Obafemi Awolowo University Teaching Hospital, Ile-ife, Nigeria
Muyiwa Afolabi Owojuyigbe

Department of Anaesthesia and intensive care, College of Health Sciences, Obafemi Awolowo University, Obafemi Awolowo University Teaching Hospital, Ile-ife, Nigeria
Oluwakemi Tolu Adegoke

Department of Paediatrics and Child Health, Obafemi Awolowo University Teaching Hospital, Ile-ife, Nigeria

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APA Style

Olugbenga Olalekan Ojo, Uvie Ufuoma Onakpoya, John Akintunde Okeniyi, Anthony Taiwo Adenekan, Muyiwa Afolabi Owojuyigbe, et al. (2019). Atrial Septal Defect with Rheumatic Mitral Regurgitation: A Rare Association in a Nigerian Child. International Journal of Cardiovascular and Thoracic Surgery, 5(3), 60-63. https://doi.org/10.11648/j.ijcts.20190503.12

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ACS Style

Olugbenga Olalekan Ojo; Uvie Ufuoma Onakpoya; John Akintunde Okeniyi; Anthony Taiwo Adenekan; Muyiwa Afolabi Owojuyigbe, et al. Atrial Septal Defect with Rheumatic Mitral Regurgitation: A Rare Association in a Nigerian Child. Int. J. Cardiovasc. Thorac. Surg. 2019, 5(3), 60-63. doi: 10.11648/j.ijcts.20190503.12

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AMA Style

Olugbenga Olalekan Ojo, Uvie Ufuoma Onakpoya, John Akintunde Okeniyi, Anthony Taiwo Adenekan, Muyiwa Afolabi Owojuyigbe, et al. Atrial Septal Defect with Rheumatic Mitral Regurgitation: A Rare Association in a Nigerian Child. Int J Cardiovasc Thorac Surg. 2019;5(3):60-63. doi: 10.11648/j.ijcts.20190503.12

Copy | Download

@article{10.11648/j.ijcts.20190503.12,
  author = {Olugbenga Olalekan Ojo and Uvie Ufuoma Onakpoya and John Akintunde Okeniyi and Anthony Taiwo Adenekan and Muyiwa Afolabi Owojuyigbe and Oluwakemi Tolu Adegoke},
  title = {Atrial Septal Defect with Rheumatic Mitral Regurgitation: A Rare Association in a Nigerian Child},
  journal = {International Journal of Cardiovascular and Thoracic Surgery},
  volume = {5},
  number = {3},
  pages = {60-63},
  doi = {10.11648/j.ijcts.20190503.12},
  url = {https://doi.org/10.11648/j.ijcts.20190503.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20190503.12},
  abstract = {Atrial septal defect (ASD) coexisting with mitral valve regurgitation has been described in literature with various aetiologies and pathophysiologic mechanisms. Mitral valve lesions coexisting with an ASD could either be congenital or acquired. The most prominent congenital mitral valve pathology is a cleft in the anterior leaflet of the mitral valve, as seen in patients with partial atrio-ventricular septal defects. Acquired mitral valve lesions include, hemodynamic induced annular dilatation resulting in significant mitral regurgitation, iatrogenic leaflet perforation and coexisting diseases such as infective endocarditis or rheumatic valve disease. However, the aetiology of the mitral valve regurgitation being due to rheumatic heart disease is uncommon. We report the case of a 12-year-old female who presented with easy fatigability, palpitation and a precordial bulge dating about 2 years. Examination revealed cardiac murmurs in the apex and pulmonary areas and transthoracic echocardiography confirmed the presence of an Ostium Secundum ASD and features of severe rheumatic mitral valve regurgitation. Child was initially placed on medications which included diuretics and an Angiotensin converting enzyme inhibitor ACEi, before she eventually had surgical closure of ASD and mitral valve replacement. The purpose of this case report is to highlight the symptomatology, diagnosis and treatment of this rare association, particularly in our environment.},
 year = {2019}
}

Copy | Download

TY  - JOUR
T1  - Atrial Septal Defect with Rheumatic Mitral Regurgitation: A Rare Association in a Nigerian Child
AU  - Olugbenga Olalekan Ojo
AU  - Uvie Ufuoma Onakpoya
AU  - John Akintunde Okeniyi
AU  - Anthony Taiwo Adenekan
AU  - Muyiwa Afolabi Owojuyigbe
AU  - Oluwakemi Tolu Adegoke
Y1  - 2019/09/18
PY  - 2019
N1  - https://doi.org/10.11648/j.ijcts.20190503.12
DO  - 10.11648/j.ijcts.20190503.12
T2  - International Journal of Cardiovascular and Thoracic Surgery
JF  - International Journal of Cardiovascular and Thoracic Surgery
JO  - International Journal of Cardiovascular and Thoracic Surgery
SP  - 60
EP  - 63
PB  - Science Publishing Group
SN  - 2575-4882
UR  - https://doi.org/10.11648/j.ijcts.20190503.12
AB  - Atrial septal defect (ASD) coexisting with mitral valve regurgitation has been described in literature with various aetiologies and pathophysiologic mechanisms. Mitral valve lesions coexisting with an ASD could either be congenital or acquired. The most prominent congenital mitral valve pathology is a cleft in the anterior leaflet of the mitral valve, as seen in patients with partial atrio-ventricular septal defects. Acquired mitral valve lesions include, hemodynamic induced annular dilatation resulting in significant mitral regurgitation, iatrogenic leaflet perforation and coexisting diseases such as infective endocarditis or rheumatic valve disease. However, the aetiology of the mitral valve regurgitation being due to rheumatic heart disease is uncommon. We report the case of a 12-year-old female who presented with easy fatigability, palpitation and a precordial bulge dating about 2 years. Examination revealed cardiac murmurs in the apex and pulmonary areas and transthoracic echocardiography confirmed the presence of an Ostium Secundum ASD and features of severe rheumatic mitral valve regurgitation. Child was initially placed on medications which included diuretics and an Angiotensin converting enzyme inhibitor ACEi, before she eventually had surgical closure of ASD and mitral valve replacement. The purpose of this case report is to highlight the symptomatology, diagnosis and treatment of this rare association, particularly in our environment.
VL  - 5
IS  - 3
ER  -

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